St. Francis by the Lake Episcopal Church
"Parent's Night Out"
Registration Form, Permission Slip and Release of Liability
I give my permission for my child,
______________________________, to attend "parent's Night Out"
at St. Francis by the Lake Episcopal Church.
I believe that St. Francis by the Lake
Episcopal Church, its Council, officers, employees, and
volunteers are exercising due diligence in caring for my child,
while he or she attends "Parent's Night Out".
However, in the event that
my child should need medical attention while attending "Parent's
Night Out", I give my express permission to the employees or
volunteers to seek medical attention on behalf of my child.
I release St. Francis by the
Lake Episcopal Church, its council, officers, employees, and
volunteers from any claim or cause of action which could result
from my child's attendance at "Parent's Night Out".
PARENT (both parents' signatures are
preferred)
________________________________________
Contact #______________________
_____________________Date ___________
SIGNATURE
________________________________________
Date __________________
SIGNATURE______________________________
CHILD'S NAME:
____________________________
Photo Release
I authorize St. Francis by the Lake
Episcopal Church to use my child's photograph for church
publications and its website postings.
CHILD'S NAME:
___________________________________
PARENT'S SIGNATURE:
___________________________________
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